Jeng S F, Wei F C, Noordhoff M S
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital at Kaohsiung, Chang Gung Medical College, Taiwan, Republic of China.
Ann Plast Surg. 1995 Dec;35(6):595-600. doi: 10.1097/00000637-199512000-00007.
Seven patients with extensive loss of soft tissue, extensor tendon, and exposure of bone and joint of dorsum of hand and foot were treated with free composite flaps from the groin area. To retard the adhesion by scarring, membrane interposition between tendon and bone was recommended. The groin flap, based on superficial circumflex iliac vessels, was combined with a well-vascularized external oblique aponeurosis. The groin skin flap provided skin coverage, and the aponeurosis was used simultaneously to create a gliding surface for reconstructed tendons in a single one-stage procedure. All composite free-tissue transfers were successful. The advantages of this technique are: (1) a single, one-stage procedure; (2) fewer adhesions of reconstructed tendons, and no need of secondary tenolysis; and (3) good cosmesis and minimal morbidity at donor site.
7例手背及足背软组织广泛缺损、伸肌腱损伤、骨与关节外露的患者采用腹股沟区游离复合组织瓣进行治疗。为减少瘢痕粘连，建议在肌腱与骨之间置入膜。以旋髂浅血管为蒂的腹股沟皮瓣与血运良好的腹外斜肌腱膜相结合。腹股沟皮瓣提供皮肤覆盖，同时利用腱膜为重建肌腱创造一个滑动面，在单一的一期手术中完成。所有游离复合组织移植均获成功。该技术的优点包括：（1）单一的一期手术；（2）重建肌腱粘连较少，无需二次肌腱松解术；（3）美容效果好，供区并发症少。
